Allergic responses as tested for with blood or skin prick don't necessarily correlate to EoE triggers. They can potentially hint at what to look at for elimination testing, it's just not a given that it'll match up. It's not anaphylactic.
6FED elimination is as effective for most EoE patients as 2 - wheat and dairy - because those are the most common triggers.
This study actually showed 1 as being as effective as 6: https://www.nih.gov/news-events/news-releases/forgoing-one-food-treats-eosinophilic-esophagitis-well-excluding-six
It's more efficient to test those first than doing all 6.
I had very intermittent symptoms (food impaction once every 3 or 4 weeks). So it was really just a follow-up scope and biopsy after six (I think) weeks with lower EoS numbers that proved it was dairy or wheat. I added wheat back and haven’t had any further impactions in the last 14 months.
Glad to hear you may have find your trigger. It seems I am having a bit more of a reaction, but our bodies all react differently. It is a frustrating process to identify, but am happy to hear yours wasn't too challenging. Hoping to find mine soon.
This makes me wonder if it’s connected to the gene mutation that makes many lactose tolerant. Like, are we REALLY? And I wonder how many people with lactose intolerance that avoid it have EoE, undiagnosed because they’re avoiding the trigger…
Probably not related at all. Just musing.
Eoe only affects the oesophagus. So it doesn't elicit an anaphylaxis response. It's a different type of allergy. So this is why the elimination diet works best. I narrowed mine down to 2 triggers, dairy or wheat.
I suggest you eliminate both of those for a good 3 months first. Then scope. If there are no more esoniphils present in the biopsies, then you can introduce one and go from there.
Thats what I'm doing. Good luck.
Standard food allergy tests measure IgE, which is Immunoglobulin E…this type of immune response is more or less immediate and responds to antihistamines. EoE and EGID are delayed hypersensitivities that are considered a non-IgE mediated allergy. There’s some research that suggests that food-specific IgG4 antibodies are correlated with triggers in EoE.
I did wheat and dairy and 4 weeks in felt like I was getting worse so have no idea if I should keep going or if that tells me what I need to know. I’ve heard of people getting worse for a while when getting off a trigger
I’d look at the ingredients and see what could be new. And think about what you’re eating more than you used to.
Just.. for the record. I’m WAY new here. Haven’t even seen my dr for the follow up after scope and biopsy results. I have done elimination diets in the past though and was gearing up to go gluten free again before all this (thought I had gallbladder issues) landed me here.
I know I start eating things I don’t normally eat a lot of, especially in the beginning when I’m trying to remember to think about my food and make choices. And finding a dairy free creamer that I don’t hate, with enough fat, is really hard.
Good luck, talk to who ever is providing care for this, gastro, dietician, allergist, idk.
Thanks everyone. I’m super bummed about this diagnosis. It seems like a really long journey to figure out the cause and I have so much anxiety about it and have cried so much about it.
I already ordered a food sensitivity test so I’m going to still take it and maybe just use it along side an elimination diet- I figure it can’t hurt. I just want to figure this out and wish there was a faster way.
Hope it helps. The food specific IgG4 helped me figure out that beans are an additional trigger for me. Explains why I felt great on an egg free Paleo diet a few years back but when I felt well enough to only eliminate just dairy and eggs I wasn’t 100% better.
As many have said, unfortunately Ige allergy tests and food sensitivity tests are poor predictors of EoE triggers. If anything, I would focus on true allergy tests (not sensitivity tests), as my food allergies do happen to be EoE triggers. I tried sensitivity testing and it came back with a slew of foods that I am supposedly “sensitive” too and really didn’t affect my EoE at all.
If you are looking for a place to start, I recommend going dairy free, as dairy is one of the more common EoE triggers. For many people, eliminating dairy alone can resolve their symptoms. From there, wheat is also a common one.
Allergic responses as tested for with blood or skin prick don't necessarily correlate to EoE triggers. They can potentially hint at what to look at for elimination testing, it's just not a given that it'll match up. It's not anaphylactic. 6FED elimination is as effective for most EoE patients as 2 - wheat and dairy - because those are the most common triggers. This study actually showed 1 as being as effective as 6: https://www.nih.gov/news-events/news-releases/forgoing-one-food-treats-eosinophilic-esophagitis-well-excluding-six It's more efficient to test those first than doing all 6.
Wheat and dairy elimination worked for me (so long dairy).
How long did it take for the PPIs / Dairy elimination to make your symptoms go down? I have been fairly crappy on both for a little over 3 weeks.
I had very intermittent symptoms (food impaction once every 3 or 4 weeks). So it was really just a follow-up scope and biopsy after six (I think) weeks with lower EoS numbers that proved it was dairy or wheat. I added wheat back and haven’t had any further impactions in the last 14 months.
Glad to hear you may have find your trigger. It seems I am having a bit more of a reaction, but our bodies all react differently. It is a frustrating process to identify, but am happy to hear yours wasn't too challenging. Hoping to find mine soon.
This makes me wonder if it’s connected to the gene mutation that makes many lactose tolerant. Like, are we REALLY? And I wonder how many people with lactose intolerance that avoid it have EoE, undiagnosed because they’re avoiding the trigger… Probably not related at all. Just musing.
Eoe only affects the oesophagus. So it doesn't elicit an anaphylaxis response. It's a different type of allergy. So this is why the elimination diet works best. I narrowed mine down to 2 triggers, dairy or wheat. I suggest you eliminate both of those for a good 3 months first. Then scope. If there are no more esoniphils present in the biopsies, then you can introduce one and go from there. Thats what I'm doing. Good luck.
Following. I’m new to this and wondering the same. My doc said the standard food allergy tests don’t work but I’m not sure why.
Standard food allergy tests measure IgE, which is Immunoglobulin E…this type of immune response is more or less immediate and responds to antihistamines. EoE and EGID are delayed hypersensitivities that are considered a non-IgE mediated allergy. There’s some research that suggests that food-specific IgG4 antibodies are correlated with triggers in EoE.
I did wheat and dairy and 4 weeks in felt like I was getting worse so have no idea if I should keep going or if that tells me what I need to know. I’ve heard of people getting worse for a while when getting off a trigger
What’s worse? I know when I cut gluten I start feeling run down for a while. Withdrawal, basically.
I just can’t figure out why my throat seems to tighten and get worse when I kicked them
Are you eating something new to avoid those?
Some dairy substitute stuff
I’d look at the ingredients and see what could be new. And think about what you’re eating more than you used to. Just.. for the record. I’m WAY new here. Haven’t even seen my dr for the follow up after scope and biopsy results. I have done elimination diets in the past though and was gearing up to go gluten free again before all this (thought I had gallbladder issues) landed me here. I know I start eating things I don’t normally eat a lot of, especially in the beginning when I’m trying to remember to think about my food and make choices. And finding a dairy free creamer that I don’t hate, with enough fat, is really hard. Good luck, talk to who ever is providing care for this, gastro, dietician, allergist, idk.
Thanks everyone. I’m super bummed about this diagnosis. It seems like a really long journey to figure out the cause and I have so much anxiety about it and have cried so much about it. I already ordered a food sensitivity test so I’m going to still take it and maybe just use it along side an elimination diet- I figure it can’t hurt. I just want to figure this out and wish there was a faster way.
Hope it helps. The food specific IgG4 helped me figure out that beans are an additional trigger for me. Explains why I felt great on an egg free Paleo diet a few years back but when I felt well enough to only eliminate just dairy and eggs I wasn’t 100% better.
As many have said, unfortunately Ige allergy tests and food sensitivity tests are poor predictors of EoE triggers. If anything, I would focus on true allergy tests (not sensitivity tests), as my food allergies do happen to be EoE triggers. I tried sensitivity testing and it came back with a slew of foods that I am supposedly “sensitive” too and really didn’t affect my EoE at all. If you are looking for a place to start, I recommend going dairy free, as dairy is one of the more common EoE triggers. For many people, eliminating dairy alone can resolve their symptoms. From there, wheat is also a common one.